Operational Compliance Manager

🔥 1 hour ago

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Gravie

WebsiteLinkedInAll Job Openings

201 - 500 employees

Founded 2013

🏥 Healthcare

🛡️ Insurance

🤝 B2B

💰 $150M Private Equity Round - Gravie on 2025-05

Healthcare • Insurance • B2B

Gravie is a benefits and health insurance solutions company that helps small and midsize employers, brokers, and employees access and administer more flexible, affordable health benefits. Its flagship offerings include Comfort (a level-funded health plan), Gravie ICHRA (Individual Coverage Health Reimbursement Arrangement administration), Gravie Pay (support for healthcare costs), and Gravie Care; the company focuses on enabling SMBs to offer individualized, lower-cost coverage and simplifying benefits administration.

📋 Description

• Serve as the primary point of contact and subject matter expert for compliance matters within assigned high-risk operational areas, such as claims processing, account management, eligibility, or appeals • Conduct compliance risk assessments, identifying potential vulnerabilities and developing mitigation strategies tailored to the unique processes of the high-risk areas • Independently translate complex regulatory requirements (e.g., CMS, ERISA, state departments of insurance) into actionable operational steps and business requirements, with oversight and direction from your leader • Review and approve operational policies, procedures, letter templates, and training materials for compliance with all applicable laws and regulations • Act as the liaison between the central Compliance Hub and assigned operational Spokes, ensuring consistent application of compliance standards • Facilitate the intake and resolution of compliance inquiries from the operational areas, coordinating with specialized teams within the central Hub as needed • Ensure timely and accurate compliance reporting from the operational areas to the central Compliance Hub • Design and execute targeted compliance monitoring activities and control testing for high-risk processes • Assist in the preparation for and response to internal and external audits

🎯 Requirements

• Bachelor's degree in a relevant field (e.g., Healthcare Administration, Business, Law, Finance) • 4+ years of experience in health plans operations, including experience developing and implementing compliant processes and supporting documentation • 4+ years of experience or in-depth knowledge of federal and state healthcare regulations (e.g., ERISA, Affordable Care Act) • 3+ years of experience interpreting complex regulations and applying them to business operations • 3+ years of experience clearly communicating, both written and verbally, with the ability to influence and consult effectively with all levels of the organization

🏖️ Benefits

• alternative medicine coverage • flexible PTO • up to 16 weeks paid parental leave • paid holidays • 401k program • transportation perks • education reimbursement • 2 days of paid paw-ternity leave